Creatine and Creatinine

Creatine is present in muscle, brain and blood. It is particularly important in its phosphorylated form as an immediate store of high-energy phosphoryl bonds for the generation of ATP from ADP. The chemical energy for the first few seconds of muscle contraction are supplied by ATP generated from this source. EXAMPLES OF DEFECTS IN AMINO ACID METABOLISM X conversion of phenylalanine to tyrosine 1 in 10 000 births mental retardation X levels of cysteine and cystine levels of homocystine and...

Positioning

The sniffing the morning air' position is the most important manoeuvre that can improve intubating conditions. The neck is flexed on the chest to about 35 degrees, this can usually be achieved with one pillow under the head. The head is then extended on the neck so that the face is tilted back 15 degrees from the horizontal plane. In this position the oral, pharyngeal and tracheal axes are aligned. The practice of placing one hand on the chin and the other on the back of the head to force the...

Rheumatoid Arthritis

Rheumatoid arthritis is an auto-immune connective tissue disease. The dominant pathological feature is a chronic, destructive synovitis, which causes an inflammatory, typically symmetrical, deforming polyarthritis. Rheumatoid arthritis has many extra-articular features which greatly influence the morbidity and mortality of the disease Figure PR.15 . Approximately 70 of patients are positive for rheumatoid factor, which is a circulating IgM antibody to the patient's own IgG. The overall...